Health | The mutual health insurance market: how to navigate?

2023-08-16 09:15:47

Mutual health insurance: tougher competition than ever in 2023

The competition of health insurance in France is even tougher this year given the soaring prices estimated at 5.9% in 2022. The health sector finds itself very affected in relation to energy costs and is also suffering the pangs of the post-crisis sanitary.

Secondly, experts attribute this increase to soaring healthcare costs for the French. The new measures imposed by the government do not help the players in the insurance sector. The rebound effect of the crisis observed in 2021 continues into 2023. This is justified by the high number of consultations and hospitalizations in medical practices in 2020, which has created a void that is difficult to fill. THE health expenditure have multiplied rapidly, at a rate of around 10% (€49 on average per French person).

On the other hand, the 100% health reform is also a factor that justifies the rise in the costs of mutuals in France. It is a device that allows you to obtain full reimbursement of certain health costs. Many low-income households have been using it in recent months to purchase medical products.

If it is an interesting solution for the population, it is nevertheless very expensive to mutuals who need to increase their spending. In total, this device has caused a 20% increase in the cost of optical, dental and audiology care.

In the last position, we also note that the taxation of mutual insurance companies in France is 8 times higher in 2021 than in 2000, thus going from 1.8 to 13.3%. Added to this is the Covid tax of 2020 and 2021 (nearly 1 billion euros) which has completely weighed down the funds of the organizations. These cost surcharges are systematically reflected in the amount of contributions applied to the insured.

The best ways to compare and sort mutuals

Faced with the inflation observed in the mutual health sector, many policyholders are looking for a new, more advantageous contract. In this sense, the comparison of complementary is the best solution available to them. For this, it is important to draw up a list of all the needs in order to better orient your research. You can use online comparators to go quickly and easily find the mutual that suits your profile. This solution allows you to have different quotes without obligation and above all, free of charge.

The first criterion to consider is the upper limit for the reimbursement of treatment costs and the purchase of medication or glasses. Some mutuals make better proposals compared to others, but be careful to check what type of reimbursement it is. A diabetic, for example, should favor companies that offer good coverage to cover all expenses related to this condition.

To also ensure the effectiveness of its mutual, it may be interesting to check the exclusions, the coverage periods and all the specifics of the contract. In general, mutuals offer a level of minimum care and good options to the insured. Similarly, you can take out health coverage as a duo to save money. The offers in pairs are often more advantageous.

Mutual health

DR

The most important guarantees

The essential guarantees differ from one insured to another. We choose the terms of his mutual considering the fact :

• his age,

• his health,

• their care habits,

• the various beneficiaries of the contract.

Mutuals offer various formulas according to the age group of the clientele. We can have offers for juniors, active and seniors. However, it can also happen that the insurance company does not impose an age limit on its subscribers.

In terms of health status, it is important to identify their main health care needs. What are we suffering from? What is his medical history? What treatments are recurring? At the same time, one can also review the frequency of attendance at health facilities and the reasons for all visits. The answers to these different questions are important to eliminate guarantees useless from his insurance contract.

On the other hand, if it is a group contract, the rules are to be applied individually. This involves considering the expectations and needs of each member to ensure coverage is suitable for all participants.

It is useful to provide the guarantee of consultation for general and specialized medicine (only for the conditions from which one suffers). The insured must also consider taking charge of purchase of essential drugs whose costs are high.

Added to this are the costs of analyses, medical examinations and hospitalization. If necessary, dental and optical guarantees can be supplemented to prevent possible risks. The objective is to maximize the chances of benefiting from a full support or majority in the event of illness, crisis or accident.

Mutual health
Mutual health

DR

Future developments in the operation of mutuals

In general, the French have a good perception mutuals, their role and the place they currently occupy in society. It is a solution that has succeeded in democratizing the standard model of property and personal insurance. However, even if it is a useful economic model, it now faces various challenges on a societal level.

Technological advances, inflation, the influx of new needs, employee demands, greatly increased competition and the generational effect are impacting factors. To stay on trend, mutuals must evolve like all other organizations trying to align with new realities.

According to a recent study, 67% of the French population expects to be more than simple “payers” of mutuals. Every citizen wishes to benefit from a more personalized relationship with organizations thanks to the digital solutions available.

This is a particular request that requires a modification of the managerial plans established for many years. Moreover, various examples have already proven that transformation projects are very difficult shifts for companies to manage. Faced with this complexity and the need to meet customer requirements, insurance companies need to quickly find effective solutions. Monitoring software, conversation applications and the deployment of new means of communication are proposals for innovative ideas.

Sources :

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